Successful transungual surgical excision of a painful subungual glomus tumor of the third fingernail in a young male patient with excellent outcome

Glomus tumors are uncommon benign vascular neoplasms originating from the glomus body, most frequently affecting the subungual region, where they often cause disproportionate pain and functional distress. Despite their small size, these tumors can significantly impair daily activities due to severe localized pain, pressure sensitivity, and cold intolerance. We describe a 29-year-old male who presented with an 8-month history of persistent, sharp pain involving the third fingernail of the left hand, leading to marked discomfort during routine tasks. Classical clinical signs, including positivity for Love’s pin test, Hildreth’s test, and cold sensitivity testing, raised strong clinical suspicion. Dermoscopy and high-resolution ultrasonography with Doppler further supported the diagnosis by demonstrating a vascular subungual lesion. Complete excision was achieved through a transungual surgical approach, involving temporary nail plate avulsion followed by repositioning of the original nail plate as a biologic dressing. Histopathology confirmed the diagnosis, and the patient experienced immediate and sustained symptom relief, with excellent cosmetic and functional outcomes at follow-up.